TITLE

Muscle-sparing versus posterolateral thoracotomy: a prospective study

AUTHOR(S)
Athanassiadi, Kalliopi; Kakaris, Stamatios; Theakos, Nick; Skottis, Ion
PUB. DATE
March 2007
SOURCE
European Journal of Cardio-Thoracic Surgery;Mar2007, Vol. 31 Issue 3, p496
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Abstract: Objective: Although the thoracotomy incision is guided in part by the exposure required, both cosmesis and the potential for improved recovery are important factors to be taken into account. We conducted a prospective randomized study in order to compare muscle sparing thoracotomy (MST) and standard posterolateral thoracotomy (PLT) for postoperative pain and physical function during and after hospitalization. Material and method: One hundred patients operated from June through December 2004 were recruited in this study. Fifty patients underwent MST of 6–8cm and 50 had a PLT of more than 8cm with division of latissimus dorsi and serratus anterior muscles. Operations performed were atypical resections and lobectomies. Pneumonectomies and operations on tumors invading the chest wall or brachial plexus were excluded. Perioperative care was standardized concerning analgetics and physiotherapy. Postoperative pain (quantitated by the visual analogue scale), preoperative and postoperative pulmonary function, shoulder strength, and range of motion were evaluated. Results: There was no difference in demographics, tumor stage, and type of lung resection. Patients were also matched for the number of chest tubes, length of chest tube duration, and length of hospital stay. Pain reported during hospitalization and after hospital discharge within 1 and 2 months did not differ within the two groups (p >0.05). Shoulder function was shown to decrease less in cases of MST, but physical function was not found statistically significant in comparison of the two groups (p >0.05) within 1 month. Rehabilitation was also similar. Conclusion: The rates of occurrence of acute or chronic pain and morbidity were equivalent after MST and PLT. It appears that the single advantage of MST over PLT involves the preservation of chest wall musculature in case rotational muscle flaps should be needed along with a better cosmetic result.
ACCESSION #
24141321

 

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